


Grace Under Pressure: A Guide to the Care and Keeping of Your Chronically Ill Cyborg Supersoldier from the Future

by stellarators (starfoozle)



Category: Terminator (Movies), Terminator - All Media Types
Genre: Alternate Canon, Chronic Illness, Chronic Pain, Disability, Fanwork Research & Reference Guides, Fix-It of Sorts, Gen, Medical Procedures, Meta, Movie: Terminator: Dark Fate, Worldbuilding
Language: English
Status: In-Progress
Published: 2020-04-17
Updated: 2020-04-28
Packaged: 2021-03-01 22:16:01
Rating: General Audiences
Warnings: No Archive Warnings Apply
Chapters: 2
Words: 2,987
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/23704495
Author URL: https://archiveofourown.org/users/starfoozle/pseuds/stellarators
Summary: Grace Harper's body has undergone both mechanical and chemical augmentation to help her fight Terminators, but these enhancements come with some serious drawbacks. Because of how her body has been altered to optimize her for brief, intense battles, she experiences severe physiological consequences and requires medication and cooling to survive the resulting post-combat “crash” -- which makes for some really interesting fanfiction.This piece of meta is intended as a reference guide for Terminator: Dark Fate fic writers who don't want to comb through a bunch of medical literature or figure out how to theoretically metal-plate a human skeleton just to finish their stories. In this write-up, we’ll take a look at what happens to Grace’s body during a crash, the medications she requires and what each is used for, and what kind of ongoing care she’s likely to need both immediately post-combat and in day-to-day life for managing the complications that might come with having a heavily medicalized body that is both enhanced and disabled. Additional chapters will include notes on how each of her augmentations might function and affect her combat ability along with her day-to-day life, particularly her power source.
Comments: 3
Kudos: 24
Collections: Terminator: Dark Fate Prompt Meme





	1. Grace, Crashing

Grace Harper's body has undergone both mechanical and chemical augmentation to help her fight Terminators. In addition to her strengthened bones and muscles, protective subdermal mesh, and enhanced senses and reflexes, her metabolism has been adjusted to provide a powerful burst of energy in combat in order to improve her odds of surviving an encounter with a Rev-9. Grace’s augmentations do come with some serious drawbacks, however. Because of how her body has been altered to optimize her for brief, intense battles, she experiences severe physiological consequences and requires medication and cooling to survive the resulting post-combat “crash”. 

In this write-up, we’ll take a look at what happens to Grace’s body during a crash, the medications she requires and what each is used for, and what kind of ongoing care she’s likely to need both immediately post-combat and in day-to-day life for managing the complications that might come with having a heavily medicalized body that is both enhanced and disabled. 

**Grace, Crashing**

So what exactly happens to Grace during combat that messes her up so badly? There’s a couple factors at play:

  * **Rhabdomyolysis** is a dangerous condition in which skeletal muscle rapidly breaks down after intense exercise or crushing injuries, both of which Grace is likely to sustain. Damaged muscle tissue releases high levels of myoglobin and potassium into the bloodstream, which can cause permanent injury to the kidneys and heart along with tissue necrosis. Symptoms include muscle pain, an irregular heartbeat, weakness, and confusion, and most of the medications Grace takes from the pharmacy actually do correspond to first-line treatments for rhabdo.
  * Grace’s nervous system has been partially rewired to improve her reflexes and interface with her mechanical components and HUD, and she may experience a form of **dysautonomia** after combat due to many of the functions of her autonomic nervous system like her heart rate, respiration, blood pressure, and adrenaline production being artificially modulated during a fight to optimize her body’s performance. There are many different subtypes of dysautonomia, but common symptoms relevant to Grace include dizziness, fainting, low blood pressure, rapid heart rate, and an inability to regulate body temperature.
  * Grace also seems to have trouble with thermoregulation: her body overheats dangerously in combat, leading to symptoms of **heatstroke**. Intense exertion in the hot climate of northern Mexico and the southern US are likely also exacerbated by those aforementioned tweaks to her metabolism and nervous system, leading to difficulty cooling down. Symptoms include rapid heart rate, difficulty breathing, disorientation, seizures, and unconsciousness.



**Medication List**

In addition to needing a lot of water and ice packs to rapidly cool herself down, Grace requires a set of medications to treat her crash symptoms, which she mostly manages to grab at the pharmacy before passing out. I’ve bolded the meds she lists aloud in the movie, and have added additional recommended ones in italics below.

  * A nonspecific **anticonvulsant** : used to prevent the heatstroke- or glitchy-augmented- nervous-system-induced seizures she’s facing in short order. _Gabapentin_ in particular is also good for managing nerve pain. She also lists off **benzodiazepine** , which is a type of anticonvulsant with sedative and muscle relaxant properties.
  * **Sodium polystyrene sulfonate** : used to treat hyperkalemia (excess levels of potassium in the body), which is caused by rhabdomyolysis from her damaged muscle tissue.
  * **Insulin** : a first-line therapy used to protect the heart from the effects of acute hyperkalemia – surprisingly not for blood sugar regulation in this case! However, for it to be administered safely, it would need to be supplemented with the additional medications listed below.
  * _Dextrose, calcium gluconate_ , and _sodium bicarbonate_ should all be administered alongside the insulin to protect her from dangerously low blood sugar, counterbalance elevated potassium levels, and treat acidosis in her blood, respectively.
  * If Grace has trouble getting her heart rate and blood pressure back under control in a crash, a _beta blocker_ will reduce both by reducing the action of adrenaline in her system.
  * A _non-steroidal anti-inflammatory (NSAID)_ isn’t listed, but is probably a good idea as both a pain reliever and fever reducer. Naproxen is very helpful stuff. In extreme circumstances, _opioids_ work well for managing nerve pain, but they’re not recommended long-term for a whole host of reasons.



**Symptom Management (Post-Movie Fix-It Fic Edition)**

Even when Grace isn’t dealing with the immediate aftermath of battling a homicidal robot, life as a cyborg is not unlike life with a chronic illness. Despite the superhuman strength and senses her augmentations afford her, her ongoing need for medication and other forms of symptom management means she’ll need to get by with more than a little help from her friends in post-movie fix-it fics.

  * Getting to know Sarah Connor’s network of off-the-grid, no-questions-asked, back-alley allies is going to be essential to keeping Grace alive and healthy, since she can’t really get medical care in any sort of above-the-board context. Now’s the time to break out your retired combat medic, veterinarian, disbarred surgeon, street medic, and former-nurse-turned-weird-hippie OCs.
  * Finding a consistent source of medication will be an ongoing challenge: there are plenty of pharmacies to be robbed, but it might be even better to have our heroes meet a sketchy doctor who’s willing to write a prescription, a hacker who’s willing to forge one, or even an anarchist biohacker group who manufactures their own medication (look up Four Thieves Vinegar Collective for some real-life inspiration).
  * Let’s actually have our heroes spend some time getting Grace’s appropriate medication dosages and forms of administration figured out! Some of these drugs metabolize best when injected intramuscularly and some work best injected into a vein, while others are best ingested orally – mixing all of them together in a water glass to load emergency syringes is definitely not the most effective option.
  * Gas station snacks are Grace’s friend. After a fight she’s likely to have burned through a lot of her body’s energy reserves and could use some junk food to get her blood sugar stabilized, especially if she’s just had to take some insulin. Sarah Connor’s predilection for potato chips might also come in handy – increased salt intake is a regular treatment for dysautonomia-induced low blood pressure, and Lay’s Salt & Vinegar or Dill Pickle flavors come highly recommended in particular.
  * Water works well for rehydration, but Pedialyte is even better, and Gatorade can be used in a pinch, especially if Grace could benefit from the extra salt and sugar. 
  * A high-protein diet is beneficial for healing damaged tissue as well as maintaining a buff physique: I get the sense that Grace would be all over a Waffle House t-bone steak and three-egg omelette special at any available opportunity. Lots of opportunities here for bonding at grungy diners, or moments of Dani and Sarah looking on in mild horror as Grace single-handedly consumes a family-sized bucket of KFC when left to her own devices.
  * Like anyone living with chronic illness or disability, Grace is likely to have good days and bad days health-wise. She’s been through a lot of extremely invasive medical interventions and survived a lot of physical and mental trauma, and it would not be unexpected for her to deal with chronic pain or other inconvenient side effects from her augmentations, which won’t magically go away even if she does survive the events of the movie and our heroes get a break from being on the run all the time. This in no way precludes having a good and well-lived life.
  * Allow for rest: all three of our heroes will be much better off if they get a little time to recover in between missions. Go forth and, armed with this knowledge, write as much h/c and fluff fic as your hearts desire.




	2. On Grace's Power Source

**Summary for the Chapter:**

> The thing we all must accept within our hearts about the Terminator franchise is that the science in them is…bad. Here is an attempt to fix some of that with a crash course in nuclear engineering. Let’s take a look at Grace’s power source in Terminator: Dark Fate, hash out some technical details of how it might work, why it could be weaponized, and to what degree she might be able to survive without it.

_**So what is that power source, anyway?** _

Grace has a power source implanted in her abdomen that charges all of her electrical augmentations: it’s a relatively small but powerful energy storage device that, when damaged in the final scenes of the movie, produces an electromagnetic pulse intense enough to fry a Terminator. Despite what’s in the script, however, it is almost certainly not a “thorium micro-reactor” as described.

Regardless of what you may have heard from b-movies through the years, a nuclear reactor is essentially just a high-tech way of boiling water. The heat generated by the reaction of a given nuclear fuel source is used to boil water, which creates steam, which rotates turbines that then create electricity. Future shit or not, a miniaturized steam engine is unlikely to fit inside a human body – what’s far more probable is that Grace’s electrical components are powered by an **atomic battery** instead. 

There are several forms of atomic batteries that actually exist in real life, and some have been in operation for more than half a century. Unlike a nuclear reactor, the heat given off by the radioactive source in an atomic battery is converted directly into electricity by a device called a thermopile (a stack of thermocouples, which convert thermal energy into electricity using the Seebeck effect, which in turn is based on the temperature difference between two different types of metals or semiconductors inducing an electrical current between one another). Plutonium-powered pacemakers were developed and successfully installed in humans in the 1970s to great success, as the long life of the tiny amount of radioactive material meant that cardiac patients wouldn’t have to undergo surgery to get their batteries replaced every few years and the devices would last them the rest of their lives – plutonium-238 has a half-life of approximately 85 years, which is more than enough to support a regular human lifespan. Unfortunately, thorium is not a great material to use for this kind of device – it’s not fissile on its own, meaning it needs a separate (radioactive) neutron source to start any kind of reaction. Despite extensive research, I haven’t been able to find any feasible designs for thorium-based batteries, though I did find a lot of dismissive comments about the concept on various forums full of people asking about the same thing.

Another kind of radiation-powered device known as a **betavoltaic cell** converts high-energy beta particles emitted from the decay of radioactive isotopes directly into electricity through some physics that are above my pay grade, rather than simply using heat – tritium (a radioactive isotope of hydrogen) and nickel-63 are both popular source materials in this technology. Betavoltaic cells are especially promising as a new kind of power source – in 2018, a team of Russian researchers developed a small nickel-based betavoltaic device that contains ten times the amount of energy as a similarly-sized electrochemical battery. It’s an exciting bit of engineering that I’d love to see more science fiction play around with, and is my personal favorite choice for Grace’s power source in the movie – some sort of very powerful betavoltaic cell powered by tritium would be body-safe and energy-dense enough for her augmentations for sure. 

A more unusual non-radioactive option is an emerging branch of technology known as **spintronics** – essentially magnetic batteries that are charged by passing a series of nano-magnets through a strong magnetic field to “wind them up” like a toy car and induce an electromotive force. Further details are once again above my pay grade, but this technology is expected to be useful for building more efficient solid-state hard drives – maybe useful for some murderous machines in our narrative, and possibly a technology that’s then re-appropriated by the Resistance? These could certainly produce an electromagnetic pulse – more on that in a bit. 

**_Okay, so how did they do that to her?_ **

In the context of the Terminator franchise, much of the technology used by the resistance is pirated and reverse-engineered from the Terminators themselves. Nuclear batteries would be a convenient family of power sources for machines that don’t have to worry about the long-term effects of radiation: they’re stable, very long-lasting, and have the useful side effects of poisoning humans who blow them up. Grace’s power source is likely modified Terminator technology, which in turn likely originated from cutting-edge military tech developed for human use sometime in the 2020s. 

I’ve taken a look at Grace’s X-rays and they’re an incomprehensible jumble of metal (which we are also ignoring for the sake of functionality – more on that in a later section) so it’s difficult to see where the reactor is actually installed in her body. It seems like there may be some sort of support structure attached to her ribs that could hold the reactor more or less in place, but it’s anyone’s guess – we can chalk that utterly bizarre X-ray from the ICE facility up to the metallic subdermal mesh plus all her metal bits putting out a weird image and just disregard it because it makes absolutely zero sense. The device is likely tucked into her abdomen roughly behind her stomach and between her kidneys, not especially likely to irradiate her or anyone else if left undamaged, and really not designed to be taken back out again.

This device’s ability to be used as an improvised EMP weapon capable of stopping the Rev-9 is a key plot point, to my eternal frustration. Electromagnetic pulses, much like nuclear tech, are also poorly understood and badly portrayed in science fiction. EMPs can take many forms – lightning strikes are a perfect example of a type we all encounter on the regular! The power surge from shoving the power source into the Rev-9’s eye socket was enough to short-circuit it for good, passing a powerful enough current through its skeleton to fry and partially melt it. It was not whatever nuclear material that was in her battery that was the lethal component, it was the electric and magnetic currents it produced on contact with the Rev-9’s metal body – which means there were likely other ways of defeating the machine had they gotten to a different location. **Some options might include:**

  * Trapping it in an induction furnace at a foundry and letting the magnetic current melt it.
  * Electrocuting it with a power line or having some final showdown at a substation and just using high voltage to fry it.
  * Sticking it in an MRI?? Good luck.



**_What does this all mean for the story?_ **

Grace’s power source was sort of an irradiated Chekov’s gun in Terminator: Dark Fate – as soon as we saw that the EMP weapons from Sarah’s military contact were damaged, I had a grim idea of where the movie was going with a cyborg who had something radioactive implanted in her body. However, we’re really all here for the “Grace lives” AUs. You can go several ways with this: 1) leave her power source alone and have her survive the end of the movie because she’s not dealing with massive abdominal trauma, 2) have her lose the power source but _not_ immediately die and find a clever narrative way to save her: _she does not necessarily need the power source itself to survive_.

Grace’s power source operates her electrical augmentations, not the organic parts of her body. She’d still have a bunch of metal implanted in her but would no longer be able to use her heads-up display enhancing her vision, her enhanced hearing, and her super-fast reflexes, as those are all controlled by electronic components that interface with her nervous system. This would likely result in some neurological impairment (the severity of which could fluctuate depending on your narrative needs) and relatively limited senses compared to what she’s gotten used to from her augmentations. Her metabolism, healing ability, and reinforced bones would be unaffected, and her major organ systems don’t run on the power source and so should be unaffected by its removal if she somehow survives the encounter at the dam and gets immediate medical treatment – it’s a stretch, but what is fanfiction for if not creative liberties in who gets to have a happy ending after all. (See the upcoming section on Grace’s ongoing medical needs for further details.)

A final note: “But the thorium micro-reactor is canon! Grace described it out loud!” To that I have two responses:

1) it’s much more likely that Grace’s power source was manufactured with energy provided from a thorium micro-reactor – research on thorium reactors has been ongoing for decades, and while they make for a poor medical device, they could provide a reliable, lower-maintenance, and relatively safe source of power for Resistance bases in a badly ecologically-damaged world, especially since thorium can be used in breeder reactors to ensure a steady fuel supply long-term.

2) Grace’s quip about Future!Dani having her tattoo the coordinates on her body “as if I couldn’t remember shit” becomes both funnier and sadder if you consider she’s just gone through some massive, traumatic bodily changes in the middle of an all-out war for the survival of the human species and might have misremembered a technical detail – she’s had to memorize a lot more immediately relevant information that’s not related to the finer points of nuclear engineering. I’ll give her a pass on this one.

**_In summary:_ **

  * Grace’s power source is most likely an atomic or magnetic battery or a betavoltaic cell; not a ~thorium micro-reactor~.
  * Ignore that X-ray in the movie, it won’t tell you anything useful about where or how the device is placed in her body.
  * There’s lots of ways to create or attract an EMP that don’t involve vivisecting our cyborg hero. 
  * If her power source is left alone, she could absolutely live a full and relatively healthy life – she’s not slowly being irradiated or anything like that; it would be very bad design.
  * Even if her power source was removed, she doesn’t necessarily need it to survive – just to power her augments. She’ll have some lasting nerve damage and other physiological consequences, but she could very well pull through.
  * Seriously, disregard both the thorium and the micro-reactor bit. Poor Grace has enough on her plate and genuinely can’t be expected to remember all this nuclear nonsense so long as it’s doing its job of keeping her alive.



**Author's Note:**

> This work is an edited and condensed version of meta originally posted on my Tumblr (@starfoozle). Special thanks to AO3 users hollywood13, who provided extensive medical consulting for this write-up; gingerandhoney, for hashing out details of chronic illness narratives and the cyborg experience; and LightDescending, for talking me into putting this up on AO3 as a fandom reference guide in the first place!


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